J Med Assoc Thai 2019; 102 (10):10

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The prognostic factors of ambulatory status in metastatic bone disease of the femur treated with intramedullary device fixation
Suthutvoravut W , Chantara T , Chandhanayingyong C , Phimolsarnti R , Asavamongkolkul A Mail, Waikakul S

Background:Nowadays, mostcancer patients have longer survivorship. These patients can sufferfrommetastatic bone disease andpresent with impendingor pathologic fracture. Femur is one of the common metastatic sites of lower extremity and can affect not onlyquality of life but also the oncologic outcome of patients with this skeletal related event. Bone stabilization is commonly procedure for patients with metastatic bone at shaft and subtrochanter of the femur. Intramedullary fixation is one of the common procedures due to mechanical benefit and less complication. This retrospectivestudy evaluated the prognostic factor of ambulatory status of the patients with mestastatic bone disease of the femur.

Objective:To evaluate the prognostic factor of ambulatory status in patientswith metastatic bone disease of the femur.

Materials and Methods:Patients with metastatic bone tumor of the femur and treated with intramedullary nailing device were retrospectively analyzed between 2007 and 2014. Thirty- one patients were enrolled in this study andwere divided into 2 groups including early ambulation group  (7 patients) and late ambulation group (24 patients).

Results:Most of the patients were performed intramedullary nail fixation without augmentation. Seven patients was additional augmented with bone cementin bone defect. Patients in early ambulation group has significant less postoperative VAS than those in late ambulation group. No significant difference in other factors such as contralateral lesion, preoperative VAS, other organ metastasis. Threepatients inlate ambulation group had urinary tract infection and 1 superficial wound infection with successfully treated by conservative treatment. One patient died from pulmonary embolism postoperatively.

Conclusion: Intramedullary nailing fixationis treatment of choicefor patients withmetastatic bone tumor of the femur. Less postoperative pain score is one of the positive factor for patients in early ambulation status. Early ambulation can provide better outcome with less complication .


Keywords:Fractures, Femur, Prognostic Factors, Pathology, Intramedullary Nailing, Ambulation

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